title: Unresponsive cutaneous leishmaniasis and HIV co-infection: report of three cases.
abstract: Cutaneous leishmaniasis (CL) is a vector borne disease caused by various species of Leishmania parasite. CL is endemic in the Thar desert of Rajasthan state and Himachal Pradesh in India. Immune suppression caused by human immunodeficiency virus (HIV) infection is associated with atypical clinical presentation of CL which responds poorly to the standard treatment and causes frequent relapses. We are reporting three cases of localized and disseminated CL due to Leishmania tropica which failed to respond to conventional intralesional/intramuscular sodium stibogluconate (SSG) injections. Initially, we did not think of HIV infection because CL is endemic in this region. When patients did not respond to SSG injections, we performed enzyme-linked immunosorbent assay (ELISA) tests for HIV and they turned out to be HIV positive. Our report showed that CL is emerging as an opportunistic infection associated with HIV/AIDS and may be the first manifestation in HIV positive patients in an endemic area.
authors.affiliation: Department of Dermatology, SP Medical College and PBM Group of Hospitals, Bikaner, Rajasthan, India.
authors.forename: Prasoon
authors.initials: P
authors.lastname: Soni
authors.forename: Neha
authors.initials: N
authors.lastname: Prasad
authors.forename: Kanika
authors.initials: K
authors.lastname: Khandelwal
authors.forename: Bhikam C
authors.initials: BC
authors.lastname: Ghiya
authors.forename: Rajesh D
authors.initials: RD
authors.lastname: Mehta
authors.forename: Ram A
authors.initials: RA
authors.lastname: Bumb
authors.forename: Poonam
authors.initials: P
authors.lastname: Salotra
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male
chemical_list: D000967:Antimony Sodium Gluconate